The purpose of this Mid-career Investigator Award in Patient Oriented Research in Female Pelvic Floor Disorders is to provide Holly E. Richter PhD, MD, Professor of Obstetrics and Gynecology in the School of Medicine at the University of Alabama at Birmingham (UAB) with significant protected time to: 1) Continue and expand her ongoing female pelvic floor disorder patient oriented research activities including serving as principal investigator of one randomized surgical trial, one randomized behavioral trial in women with urge incontinence, and three prospective trials (funded through the NICHD and NIDDK, U01 awards), including a pelvic floor imaging study that will be the focus of her research plan (NICHD). 2) To enhance her activities and capabilities as a mentor and facilitator of training of new investigators by augmenting her formal training in the design and conduct of clinical research. 3) To develop a new area of pelvic floor disorder research specifically through the establishment of a database at the UAB Genitorectal Disorder Center. Few prospective cohort or randomized trials exist in the area of Genitorectal disorders including sequelae that result from anal sphincter tear at the time of vaginal delivery, anal incontinence, rectoceles and defecatory dysfunction. Through this fellow center, a database has been developed that will facilitate the collection of data that tracks both objective and subjective treatment outcomes on all patients receiving evaluation and treatment through the clinic. Physical evaluation and objective testing can be correlated with patients'symptoms and outcome of therapy. This type of data can be used to power future trials as well as improving on patient care. The cumulative effect of this award will allow Dr. Richter to continue to make valuable contributions through high quality research and focused mentoring, to patient oriented research in women's pelvic floor health and will ensure that her education and experience will be propagated by continuously fostering other research careers. Dr. Richter has the enthusiastic support of her department, UAB investigators and other nationally recognized clinical researchers to pursue her research goals. She is a mentor to young clinical investigators and is the research director of the newly initiated Fellowship in Female Pelvic Medicine and Reconstructive Surgery at UAB